Average Daily Physical Activity Research Articles

Accelerometry-assessed daily physical activity and compliance with recommendations in Spanish children: importance of physical education classes and vigorous intensity.

Physical activity (PA) is associated with numerous health benefits. Vigorous PA (VPA) may have a greater impact on public health than lower-intensity PA. The incorporation of a specific recommendation on VPA could complement and improve existing recommendations for average daily moderate-vigorous PA (MVPA). Physical education classes could have a positive impact on children's adherence to average daily physical activity recommendations. The aim was to investigate the association between MVPA and VPA in children, as well as adherence to recommendations, and obesity and the presence of physical education classes. A cross-sectional study of physical activity was conducted in a sample of 8 and 9-year-old children in Andalusia (Spain). GENEActiv accelerometers were used, placed on the non-dominant wrist for at least eight consecutive days (24-h protocol). School days with and without physical education class, and weekend days were defined. ROC curves were used to calculate the threshold associated with obesity for average daily MVPA and VPA for recommendations. A total of 360 schoolchildren were included in the analyses (184 girls). An average of 7.7 (SD 1.4) valid days per participant were evaluated, with 19.9 (SD 10.5) and 11.4 (SD 5.1) minutes of VPA performed by boys and girls respectively. 25.8% of the participants were classified with central obesity. The optimal threshold determined with ROC analysis was 12.5 and 9.5 minutes of average daily VPA for boys and girls, respectively (RecVPA), and 75 minutes of average daily MVPA for both sexes (RecMVPA). The RecVPA showed stronger association with obesity. On school days with physical education class, compared to days without this class, children showed increased VPA and MVPA engagement and better compliance with recommendations, with smaller differences in adherence according to sex or obesity. On days with physical education class, more physical activity was accumulated at all intensities and greater adherence to the recommendations than on days without this class. VPA had a stronger correlation with the absence of obesity than lower-intensity activity. It was also observed that boys were physically more active and had higher adherence to the recommendations than girls.

Relationship between physical activity and cerebral white matter hyperintensity volumes in older adults with depressive symptoms and mild memory impairment: a cross-sectional study.

Cerebral white matter hyperintensities (WMHs) are commonly found in the aging brain and have been implicated in the initiation and severity of many central nervous system diseases. Furthermore, an increased WMH volume indicates reduced brain health in older adults. This study investigated the association between WMH volume and physical activity in older adults with depressive symptoms (DS) and mild memory impairment (MMI). Factors associated with the WMH volume were also investigated. A total of 57 individuals aged over 65 years with DS and MMI were included in this study. The participants underwent magnetic resonance imaging to quantify WMH volumes. After WMH volume was accumulated, normalized to the total intracranial volume (TIV), the percentage of WMH volume was calculated. In addition, all participants wore a triaxial accelerometer for 2 weeks, and the average daily physical activity and number of steps were measured. The levels of blood biomarkers including cortisol, interleukin-6 (IL-6), brain-derived insulin-like growth factor-1, and brain-derived neurotrophic factor were measured. Motor and cognitive functions were also assessed. Faster maximum walking speed and longer time spent engaged in moderate physical activity were associated with a smaller percent of WMH volume, whereas higher serum IL-6 levels were associated with a larger percent of WMH volume. The number of steps per day, time spent engaged in low levels of physical activity, cognitive function, and all other measured biomarkers were not significantly associated with percent of WMH volume. Higher blood inflammatory cytokine levels, shorter duration of moderate physical activity, and lower maximum walking speed were associated with a higher percent of WMH volume. Our results provide useful information for maintaining brain health in older adults at a high risk of developing dementia and may contribute to the development of preventive medicine for brain health.

Abstract P511: Physical Activity, Medical, and Mental Health Outcomes of a Pilot Multilevel Intervention for People With Metabolic Syndrome

Background/Objectives: This pilot randomized controlled trial aimed to help people with metabolic syndrome increase physical activity and well-being. Intervening on lifestyle behaviors such as physical activity, can improve metabolic syndrome outcomes. Methods: Primary care patients with metabolic syndrome were recruited from clinics across our hospital system. Eligibility criteria were: <150 minutes/week of moderate-vigorous physical activity (MVPA), having ≥2 of 5 metabolic syndrome criteria, and not having cardiovascular disease or diabetes, as this was a prevention study. The multilevel intervention (MAPP) included 8-weekly 60-minute group sessions, physical activity self-monitoring/goal setting using Fitbits, physical activity/motivational interviewing (MI) topics, positive psychology (PP) topics, a weekly group walk prior to COVID, and neighborhood walkability assessments. Participants were randomized to an immediate or waitlist control group. They wore an Actigraph GT3X+ accelerometer for one week before beginning and after the last session (8-weeks). We obtained pre-post weight measurements. Mean baseline to 8-week individual difference results were compared between groups using t-tests with unequal variances. Results: Sixty-four participants enrolled, with 32 randomized to each arm; 51 provided complete follow-up data, and 63% (10/16) of the groups were conducted virtually (post-COVID). Most (92%; 59/64) were non-Hispanic White, 69% (44/64) were female, and mean age was 60. Average daily physical activity did not increase significantly by objective measures. The estimated change in mean difference for sedentary time decreased for the intervention group compared to the control group by 46.8 minutes/day (CI: -47.5-141.1; d= 0.28). Light physical activity increased by an average of 21.0 minutes/day (CI: -13.9-55.9; d= 0.34), steps/day increased by 376.6 (CI: -949.6-1702.9; d =0.16), and moderate-vigorous physical activity increased by 4.1 minutes/day (CI: -4.5-12.8; d=0.27). The estimated change in mean weight was significant: 8.4 pounds lost for the intervention group compared to the control group (CI: -13.5-3.2; p =.002; d =0.92). Discussion: This 8-week randomized controlled trial of a multilevel physical activity PP-MI intervention was associated with small to medium effect sizes for changes in physical activity, and a significant decrease in weight, despite weight not being an intervention target. Changes of this magnitude are associated with reduced cardiovascular disease risk and mortality. These findings are all in expected directions, producing signals even amidst different modalities and COVID-19-related disruptions. We plan to test this in a larger efficacy trial with broader reach and implementation.

Abstract 51: Better Sleep Health is Associated With Greater Adherence to Lifestyle Modification During a 12-month Behavioral Weight Loss Intervention

Introduction: Consistent evidence suggests that poor sleep may impede weight loss efforts; however, the impact of poor sleep on lifestyle modification during attempted weight loss is unclear. Purpose: To examine the relationship between sleep health and measures of lifestyle modification in a sample of adults who participated in a 12-month behavioral weight loss intervention. Methods: Adults (N=125) with overweight or obesity (50.3±10.6 years, 91% female, 81% White) participated in a 12-month behavioral weight loss intervention. Assessments occurred at baseline, 6 months, and 12 months. Six dimensions of sleep were included in our operationalization of sleep health: regularity, satisfaction, alertness, timing, efficiency, and duration. Sleep dimensions were assessed using validated questionnaires and actigraphy, with values dichotomized into ‘good’ and ‘poor’ sleep. A composite sleep health score was calculated based upon the count of the ‘good’ individual dimensions (range: 0-6), with higher scores indicating better sleep health. Measures of lifestyle modification included attendance at group intervention sessions, daily adherence to caloric intake goals (% of days), and change in average daily moderate-vigorous physical activity (MVPA). Linear mixed modeling was used to examine the relationship between baseline and 6-month sleep health and lifestyle modification during the subsequent 6-month interval with adjustment for age, gender, bed partner, and race. The composite sleep health score and individual sleep health dimensions were evaluated in separate models. Results: Mean sleep health was 4.5±1.1 (mean±standard deviation) at baseline and 4.5±1.2 at 6 months; from 0-6 months and 6-12 months, participants attended 79.4±15.0% and 62.3±32.3% of the group intervention sessions, adhered to caloric intake goals on 35.6±23.3% and 21.1±23.3% of the days, and changed MVPA by 8.7±13.6 min/day and -3.7±13.6 min/day. Better sleep health was associated with higher rates of attendance at group intervention sessions (b=2.71, SE=1.29; P=.038), greater adherence to caloric intake goals (b=4.60, SE=1.34; P<.001), and a trend for greater change in MVPA (b=1.41, SE=0.82; P=.088). Associations with lifestyle modification outcomes were observed with the following individual sleep dimensions (each P<.05): regularity with attendance and caloric intake, satisfaction with caloric intake, and duration with MVPA. Conclusions: Better sleep health was associated with greater adherence to lifestyle modification during a 12-month behavioral weight loss intervention. Whether improving sleep health prior to or during a weight loss intervention facilitates better lifestyle modification outcomes merits examination. Support: NIH R01HL107370.

How to identify patients with low muscle mass linked to physical capacity and physical activity in heart failure

Abstract Introduction Skeletal muscle wasting is frequent in heart failure (HF) patients, and low muscle mass (MM) is associated with increased morbidity and mortality. Current recommendations suggest the usage of dual-energy X-ray absorptiometry (DXA)-derived appendicular lean mass (ALM) adjusted for height squared to identify low MM. However, it has recently been suggested that ALM adjusted for body mass index (BMI) has a higher predictive value. The relationships between low MM, muscle strength, exercise capacity and daily physical activity (PA) are poorly understood in heart failure with reduced ejection fraction (HFrEF). Purpose This study examined the relationships between low MM defined by two different indices and muscle strength, physical capacity tests and accelerometer measurements. Methods A total of 104 HFrEF patients underwent DXA, maximal isometric knee-extensor strength test, cardiopulmonary exercise testing, 6-minute walking test and accelerometry. Two adjusted indices for low MM were assessed: ALM/m2 and ALM/BMI. We performed Pearson correlations to examine the relationships between low MM and muscle strength, exercise capacity and daily PA. Furthermore, we identified patients with low MM based on the two indices. For ALM/m2 we used guideline-recommended cut-offs and for ALM/BMI we used the mean value since no cut-offs has been validated. Results The ALM/m2-index showed no significant correlation to peak oxygen uptake (VO2peak), 6-minute walking distance (6MWD), average PA or daily time spent in moderate-to-vigorous physical activity (MVPA). A moderate correlation was found to maximal muscle strength was found (r=0.61, p<0.001). The ALM/BMI-index was moderately correlated to maximal muscle strength (r=0.65, p<0.001), VO2peak (r=0.40, p<0.001), 6MWD (r=0.41, p<0.001), average daily PA (r=0.27, p=0.012) and daily time spent in MVPA (r=0.29, p=0.007). Patients with low MM identified by ALM/m2 did not differ from patients with preserved MM with regards to VO2peak, 6MWD or accelerometer measurements. A difference in maximal muscle strength was found (95.7±35.6 Nm vs 116±44.8, p=0.02). Patients with low MM identified by ALM/BMI had lower maximal muscle strength (94.8±36.1 Nm vs 121.9±44.4 Nm, p=0.001), lower VO2peak (13.2±3.5 mL/kg/min vs 16.4±3.7 mL/kg/min, p<0.001), shorter 6MWD (370.5±99.4 m vs 467.3±93.9 m, p<0.001), average daily PA (15.1±4.4 ENMO* vs 17.3±5.3 ENMO*, p=0.04) and daily time spent in MVPA (14.2±16.7 min vs 24.7±21.6 min, p=0.01) compared to patients with preserved MM. Conclusion In HFrEF patients low MM identified by ALM/BMI seems to correlate better to well-established markers for physical capacity (VO2peak and 6MWD), muscle strength and daily PA compared to ALM/m2. No cut-offs have been established for ALM/BMI and there is a need for longitudinal studies to determine the association with mortality in HFrEF patients. *ENMO = Euclidean Norm Minus One, an acceleration metric. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The Karen Elise Jensens Foundation

‘Tracking Together’—Simultaneous Use Of Human And Dog Activity Trackers: A Factorial Randomized Controlled Trial

PURPOSE: Human activity trackers have been shown to increase daily steps and physical activity intensity. Dog activity trackers may increase the owner’s awareness of their dog’s well-being, resulting in increased dog walking behavior, which may increase the owner’s physical activity. This study examines the impact of the simultaneous use of activity trackers by humans and their dogs on the physical activity of humans. METHODS: Fifty dog owners were randomized into one of four groups. Each group consisted of dog-human duos, in which both, human-only, dog-only, or neither were given an activity tracker to use for eight weeks. All human subjects wore a waist mounted accelerometer that quantified physical activity at two timepoints: one week prior to randomization and eight weeks after randomization. Commercial activity trackers were used during the eight-week session for tracking human and dog activity remotely. A factorial analysis of covariance was used to compare daily average sedentary, low, light, moderate, and vigorous physical activity across the four groups from pre to post. RESULTS: Change in daily average sedentary, low, light, moderate, and vigorous physical activity from fifty dog owners were analyzed (Control n = 13, Human Activity Tracker (HAT) n = 14, Dog Activity Tracker (DAT) n = 12, HAT + DAT n = 11). There was a significant main effect of HAT on change in average daily light physical activity (Avg Light PA) minutes. No HAT compared to HAT significantly increased Avg Light PA (30.83 ± 14.87 minutes/day, p = 0.04). There was a marginally significant effect of HAT on change in average daily sedentary physical activity minutes (Avg Sed PA). No HAT compared to HAT decreased Avg Sed PA (-43.8 ± 23.76 minutes/day, p = 0.07). There were no other significant changes in average daily physical activity categories. CONCLUSIONS: Simultaneous use of activity trackers did not change physical activity for this small, self-selected sample. The pandemic may have already increased dog walking for this sample, they may already have well-established dog-walking routines, or they may not have continuously worn trackers. Future studies should also explore behavioral interventions that utilize DAT for improving dog-walking behavior and other dog-engaged activities among dog-owners that positively impact health of both species.

Correlates of Moderate-to-Vigorous Physical Activity in Children With Physical Illness and Physical-Mental Multimorbidity.

This study measured physical activity (PA) and explored its correlates among children with multimorbidity (co-occurring chronic physical and mental illness; MM) versus those with chronic physical illness only (PI). This study used baseline data from the Multimorbidity in Children and Youth Across the Life Course (MY LIFE) study, an on-going cohort study following 263 children with a PI 2 to 16 years of age (mean age: 9.8 years, SD = 4.0; 47.7% female). PA was measured using accelerometry, and demographic and psychosocial variables were collected using questionnaires. Of the 55 children with MM and the 85 with PI with valid accelerometer data, 38.1% and 41.2%, respectively, met average daily PA guidelines. Correlates of moderate-to-physical PA (MVPA) among children with MM were age, ρ(53) = −0.45, p = .001, body mass index (BMI), ρ(48) = −0.28, p = .04, self-perceived behavioral conduct, ρ(24) = −0.45, p = .02, physical health-related quality of life, ρ(51) = 0.56, p < .001, and peer support, ρ(52) = 0.27, p = .04. Correlates of MVPA among children with PI were age, ρ(83) = −0.40, p < .001, sex, ρ(83) = −0.26, p = .01, self-perceived social competence, ρ(31) = 0.42, p = .02, self-perceived athletic competence, ρ(31) = 0.48, p = .005, physical health-related quality of life, ρ(83) = 0.34, p = .001, participation in community sport, ρ(31) = 0.41, p = .02, and family functioning, ρ(83) = 0.26, p = .02. These results demonstrate that children with PI and MM are insufficiently active and their PA is correlated with demographic and psychosocial factors.

Sleep Efficiency Moderates the Next-day Association between Physical Activity and Pain Intensity among Adults with Knee Osteoarthritis

Previous studies have suggested that characteristics of sleep may modulate the physical activity-pain intensity association. This study aimed to identify which sleep parameters, if any, modify the next-day physical activity-pain intensity association in adults with knee osteoarthritis. This secondary analysis used data from people with knee osteoarthritis recruited to a pacing intervention trial. Up to seven days of pre-randomization actigraphy and pain intensity ecological momentary assessments (11-point numeric rating scale, administered five times/day at quasi-random intervals) were analyzed. Separate multi-level models with average pain intensity for that day as the outcome included interaction terms between previous night's sleep variables (efficiency, onset latency, time spent awake after sleep onset, and duration) and that day's daytime physical activity variables (person-centered; total activity count, maximum activity count, and average activity count/min). Models were adjusted for age, sex, and the individual's average pain intensity over the duration of the study. In the findings, 116 participants provided 799 days of data. Mean age was 64.9 (SD 8.0), 60% were female and 87% white. At baseline, 54% could be characterized as poor sleepers, determined by scoring >5 on the Pittsburgh Sleep Quality Index. Although higher person-centered average daily physical activity count (i.e., compared to the participant's study average) was associated with lower same-day average pain intensity, significant interaction was identified between previous night's sleep efficiency and person-centered average daily physical activity (p=0.03). After nights of higher sleep efficiency, there was a stronger negative association between within-day average physical activity and pain intensity. Findings indicate that optimizing sleep efficiency may be important to maximize the pain-relieving effects of physical activity in people with knee osteoarthritis. Future studies are required to replicate these findings and to investigate other features of sleep that may be salient in the physical activity-pain association. This secondary analysis used data collected for a project supported by the Rehabilitation and Research Branch of the Veterans Affairs Office of Research Development, grant number 1I01RX000410.

Cross-mapping medical records to NANDA-I to identify nursing diagnoses in a vulnerable population.

To assess the association between vulnerable populations and nursing care needs, using NANDA-I diagnostics, in the population of the Canary Islands, Spain. Nursing social epidemiology study. Cross Mapping of Medical Records to NANDA-I to Identify Nursing Diagnoses in a Population usinga medical, epidemiological follow-up study of a cohort of 7,190 people. The level of vulnerability of the participants was assigned, among those who were also assigned nursing diagnoses, using the "ICE index" to calculate the expected associations. The most prevalent nursing diagnosis in our sample was Sedentary lifestyle (60.5%), followed by Ineffective health self-management (33.8%) and Risk-prone health behaviour (28.7%). Significant differences were found by sex, age group and social class, with the nursing diagnoses included in the study being more prevalent among the most socio-economically disadvantaged social class. The cross-mapping method is useful to generate diagnostic information in terms of care needs, using the NANDA-I classification. The expected associations between high social vulnerability and care needs have been verified in a comprehensive and representative sample of the Canarian population (Spain). From an epidemiological perspective, identifying nursing diagnoses at the population level allows us to find the most prevalent needs in the different community groups and to focus appropriate nursing interventions for their implementation and impact assessment.

Current status of regular exercise and influencing factors in 18-64 year old labor force population in Beijing

Objective: To understand the regular exercise status and influencing factors in 18-64 year-old labor force population in Beijing, and provide evidences for behavioral intervention. Methods: Data were collected from Beijing Adult Non-communicable and Chronic Diseases and Risk Factors Surveillance Program from August to December, 2017. The stratified cluster sampling method was used to select 13 240 survey subjects throughout the city. The valid sample size included in this study were 11 604 persons aged 18 to 64 years. Questionnaire was used to collection the information about basic demographic characteristics, chronic disease history and physical activity prevalence of the study subjects. The body height and weight were measured by standard methods. Fasting venous blood samples were collected for the detection of fasting blood glucose, blood lipids and other biochemical indicators. Software SPSS 20.0 was used fort complex sampling sample weighting and data analysis. Results: The proportions of the study subjects who did regular exercise and never had leisure-time activity in 18-64 year-old labor force population in Beijing were 23.74% (95%CI: 21.51%-26.12%) and 64.34% (95%CI: 61.66%-66.94%) respectively; The average daily physical activity time was 23.44 min (95%CI: 21.16-25.71), and the total daily sedentary behavior time was 6.96 hours (95%CI: 6.80-7.13). With the increase of age, the proportions of the study subjects who did regular exercise and never had leisure-time activity increased (P=0.006, P<0.001). With the increase of educational level, the proportion of those who did regular exercise increased (P<0.001), and the proportion of those who never had leisure-time activity decreased (P<0.001); the higher the level of physical activity, the higher the regular exercise proportion (P<0.001); the proportions of employed people who did regular exercise was lower than those in unemployed people (P<0.001); the proportions of women never had leisure-time activity was higher than those in men (P=0.024). The results of multivariate analysis showed that older age and higher education level were positive factors for regular exercise (35- years old: OR=0.653, 95%CI: 0.530-0.804, P<0.001; 50-64 years old: OR=0.695, 95%CI: 0.560-0.864, P=0.001; high school/technical secondary school/technical School: OR=0.679, 95%CI: 0.593-0.777, P<0.001; college graduation: OR=0.478, 95%CI: 0.387-0.590, P<0.001; bachelor degree and above: OR=0.435, 95%CI: 0.347-0.546, P<0.001), while employment (OR=1.631, 95%CI: 1.330-2.000, P<0.001) and married/cohabitation (OR=1.340, 95%CI: 1.093-1.644, P=0.038) were negative factors for regular exercise. Conclusions: The rate of regular exercise in 18-64 year-old labor force population in Beijing needs to be improved. Older age and high educational level were positive factors for regular exercise, while being married and employed were negative factors for it.

The correlation of physical activity and sedentary leisure time with low muscle mass, strength, and quality in Chinese adults

Objective: To explore the relationship of physical activity and sedentary leisure time with muscle mass, strength, and quality in Chinese adults. Methods: Based on the second resurvey of China Kadoorie Biobank (CKB) in 2013-2014, logistic regression models were used to analyze the correlation of physical activity and sedentary leisure time with low muscle mass, grip strength, and muscle quality. Results: A total of 24 245 participants were included in the analysis. The average daily physical activity level was (18.3±13.8) MET-h/d, and the sedentary leisure time was (4.4±1.9) hours. We took the lowest physical activity quartile as the reference and found that the participants' physical activity was negatively correlated to low muscle mass, strength, and quality. The ORs (95%CIs) of low appendicular skeletal muscle mass index (ASMI), low total skeletal muscle mass index (TSMI), low grip strength and low arm muscle quality (AMQ) were 0.68 (0.60-0.77), 0.66 (0.58-0.75), 0.82 (0.72-0.94) and 0.84 (0.74-0.95), respectively. The subtypes of physical activity, including those related to work, transportation, housework, and leisure, also showed negative correlations with low muscle mass, strength, and quality to varying degrees. Compared with participants with the shortest sedentary leisure time, those who had the longest were more likely to have low TSMI (OR=1.13, 95%CI: 0.99-1.30). Conclusions: Physical activity was negatively correlated with a lower risk of low muscle mass and strength, while longer sedentary leisure time positively correlated with low muscle mass.

The beneficial effect of physical activity on cognitive function in community-dwelling older persons with locomotive syndrome

BackgroundCognitive decline is closely related to motor decline. Locomotive syndrome (LS) is defined as a state associated with a high risk of requiring support because of locomotive organ disorders, and can be evaluated using a questionnaire. This study aimed to clarify the effectiveness of daily goal-targeted exercise on cognitive function in two different populations classified by scores on the Locomo 25 questionnaire.MethodsSeventy community-dwelling older people who participated in a 13-week health class were divided into two populations based on Locomo 25 scores: <7 (non-LS) and ≥7 (LS). Participants were presented with a daily target steps and worked towards that goal. Cognitive function was evaluated using the Japanese version of Addenbrooke’s Cognitive Examination-Revised (ACE-R). Average daily physical activity (exercise [Ex]) for 13 weeks was measured using a portable activity meter. Depression status was assessed using the Geriatric Depression Scale (GDS-15).ResultsNo significant differences were observed in age, years of education, body mass index, smooth muscle mass index, GDS-15 scores, or ACE-R scores between the non-LS and LS populations. Multiple logistic regression analysis showed that Ex (odds ratio = 5.01, p = 0.002) for 13 weeks was significantly associated with increased cognitive function in the LS population. The Ex threshold for the increase in cognitive function based on receiver operating curve analysis was 2.29 metabolic equivalents of task (METs) × h (METs · h/day) (p = 0.047) in the LS population. After 13 weeks, ACE-R scores were significantly higher in the Ex ≥ 2.29 than in the Ex < 2.29 METs · h/day group (p = 0.024, ηp2 = 0.241) in the LS population based on two-way analysis of covariance. Furthermore, a significant increase in the ACE-R memory domain was seen in the Ex ≥ 2.29 group (p = 0.035, ηp2 = 0.213).ConclusionsThese results suggest that Ex ≥ 2.29 METs · h/day is important for improving cognitive function in LS populations.

Day-to-day measurement of physical activity and risk of atrial fibrillation.

Aims The aim of this study was to investigate the association between within-individual changes in physical activity and onset of atrial fibrillation (AF).Methods and results A total of 1410 participants from the general population (46.2% women, mean age 74.7 ± 4.1 years) with risk factors but with no prior AF diagnosis underwent continuous monitoring for AF episodes along with daily accelerometric assessment of physical activity using an implantable loop recorder during ≈3.5 years. The combined duration of monitoring was ≈1.6 million days, where 10 851 AF episodes lasting ≥60 min were detected in 361 participants (25.6%) with a median of 5 episodes (2, 25) each. The median daily physical activity was 112 (66, 168) min/day. A dynamic parameter describing within-individual changes in daily physical activity, i.e. average daily activity in the last week compared to the previous 100 days, was computed and used to model the onset of AF. A 1-h decrease in average daily physical activity was associated with AF onset the next day [odds ratio 1.24 (1.18–1.31)]. This effect was modified by overall level of activity (P < 0.001 for interaction), and the signal was strongest in the tertile of participants with lowest activity overall [low: 1.62 (1.41–1.86), mid: 1.27 (1.16–1.39), and high: 1.10 (1.01–1.19)].Conclusions Within-individual changes in physical activity are associated with the onset of AF episodes as detected by continuous monitoring in a high-risk population. For each person, a 1-h decrease in daily physical activity during the last week increased the odds of AF onset the next day by ≈25%, while the strongest association was seen in the group with the lowest activity overall.Clinical Trial RegistrationClinicalTrials.gov, identifier: NCT02036450.

Risk and Resilience Predictors of Recovery After Spinal Fusion Surgery in Adolescents.

This prospective study examined risk and resilience predictors of pain and functional recovery in the first 6 months after spinal fusion surgery in adolescents. Adolescents with adolescent idiopathic scoliosis undergoing spinal fusion surgery (n=100, aged 12 to 18 y, 77% girls) completed assessments before surgery and at 3 weeks, 6 weeks, and 6 months after surgery. Recovery trajectories in pain, health-related quality of life (HRQOL), and objectively registered physical activity were identified. Presurgical pain catastrophizing and pain intensity (risk), and psychological flexibility, and postsurgical pain acceptance (resilience) were examined as predictors of recovery. Latent growth class analyses revealed 4 distinct pain recovery trajectories (ie, Severe-Moderate [11%, n=9], Mild-No [58%, n=49], Moderate-Mild [24%, n=20], and Moderate-Severe [7%, n=6] pain trajectory), 2 HRQOL recovery trajectories; 2 trajectories characterizing recovery in average daily physical activity at moderate-to-vigorous intensity (MVPA); and 3 trajectories characterizing recovery in total physical activity volume characterized by the average daily number of steps. Subsequent multivariate analyses of variance revealed that presurgical pain intensity (partial η2=0.21, P<0.001) and pain catastrophizing (partial η2=0.13, P<0.01) were both predictive of poorer recovery in HRQOL, and pain catastrophizing additionally predicted poorer pain recovery (partial η2=0.15, P<0.05). Psychological flexibility (partial η2=0.25, P<0.001) and postsurgical pain acceptance (partial η2=0.07, P<0.05) were predictive of more favorable recovery trajectories in HRQOL, and psychological flexibility additionally predicted more favorable recovery trajectories in postsurgical pain (partial η2=0.15, P<0.05). Daily MVPA trajectories were not significantly predicted by any of the hypothesized factors, while presurgical pain catastrophizing levels were predictive of a delayed recovery trajectory in the daily amount of steps (partial η2=0.17 P<0.01). Presurgical screening could include assessment of pain intensity, pain catastrophizing, psychological flexibility, and pain acceptance to identify adolescents who are at risk for poorer recovery. These are potentially modifiable factors that can be targeted in presurgical interventions to prevent poor and foster adaptive outcomes after major surgery in adolescents.

Clinical indicators and aetiological factors of sedentary lifestyle in patients with arterial hypertension.

The aim of this study is to verify the clinical validity of clinical indicators and aetiological factors of sedentary lifestyle in individuals with arterial hypertension. Diagnostic validation is performed to expand nursing taxonomies and to revise or confirm the described concepts. New elements listed in the literature and those identified by the NANDA International definition for sedentary lifestyle need to be evaluated. This is a cross-sectional and diagnostic validation study. The STROBE guidelines were used in this study. Two hundred and fifty subjects aged over 18years were evaluated. The diagnostic status of the participants was obtained by latent class analysis. Logistic regression was used to identify aetiological factors with the manifestation of sedentary lifestyle, considering a significance level of 5%. A total of 57.8% of the study participants met the diagnostic criteria for sedentary lifestyle. The clinical indicators with high sensitivity were as follows: "Average daily physical activity is less than recommended for gender and age"; "Does not perform physical activity during leisure time"; "Preference for activity low in physical activity" and "Overweight." The significantly related factors associated with the diagnosis of sedentary lifestyle were as follows: "Insufficient knowledge on physical activity," "Lack of time," "Negative self-perception of health," "Lack of security," "Lack of appropriate place," "Lack of motivation," "Activity intolerance," "Lack of sports ability," "Having a partner," "Using public transportation," "Perception of physical disability," "Pain," "Having a job/studying," "Laziness," "Impaired mobility," "Living in an urban area," "Education in a public institution," "Female gender," "Lack of confidence to practice physical exercise," "Education level," "Age" and "Lack of social support for the practice of physical exercise." Four out of eight clinical indicators had a good adjustment by the latent class analysis. Of the 27 aetiological factors, 22 were significantly associated with sedentary lifestyle. The correct identification of sedentary lifestyle and its elements supports care planning, especially for health promotion and disease prevention.

The relation between accelerometer‐derived physical activity and brain structure: Findings from the Rhineland Study

AbstractBackgroundPhysical activity is associated with a reduced risk of dementia. Although physical activity induces potent neuroprotective effects in animals, human studies assessing its effects on brain structure are sparse and inconclusive. The discrepancies in human studies may have been due to application of subjective physical activity measures, low spatial‐resolution imaging or small sample sizes. Therefore, we aimed to assess whether objectively quantified physical activity levels are associated with detailed measures of brain structure in a large cohort study.MethodOur analyses were based on data of the first 4,000 participants (56.6% female, mean age: 55.2 years (range 30 – 95 years)) of the Rhineland Study, a population‐based prospective cohort study in Bonn, Germany. Free‐living physical activity over seven days was continuously measured using the ActivPAL™ accelerometer. Average daily physical activity measures included metabolic equivalent (MET)‐hours, total step count, as well as minutes spent stepping or performing light and moderate‐to‐vigorous physical activities. Grey matter (GM), white matter (WM) and total brain volume (TBV) estimates were obtained from 3T MRI scans using FreeSurfer. Multivariable regression models were used to examine the association between physical activity and brain structure, with physical activity levels as independent and brain structure measures as dependent variables, while adjusting for age, sex, intracranial volume, education and smoking status.ResultDaily MET‐hours were associated with all volumetric measures of brain structure (effect estimates [in cm3/hour] for TBV: ß=2.36, 95% CI: 1.05 – 3.67; GM: ß=0.82, 95% CI: 0.15 – 1.50; WM: ß=0.97, 95% CI: 0.08 – 1.85). Importantly, we found a significant interaction between the effects of MET‐hours and age on TBV: in participants below median age the effect of MET‐hours on TBV was 0.28 cm3/hour (95% CI: ‐1.40 – 1.97), while in those above median age the effect was 2.01 cm3/hour (95% CI: 0.08–3.94). Overall, we obtained comparable findings for other physical activity measures as well (data not shown).ConclusionPhysical activity was consistently associated with grey matter, white matter and total brain volumes in a large cohort of individuals from the general population. These findings suggest that promoting physical activity could be critical in the prevention of age‐associated brain atrophy.

PSXI-33 Effects of weight loss and feeding a high-protein, high-fiber diet on blood metabolite profiles, body composition and voluntary physical activity in overweight dogs

Abstract Canine obesity can be managed by dietary energy restriction using a specifically formulated weight loss diet. The objective of this study was to determine the effects of weight loss on body composition, voluntary physical activity, and blood metabolites of overweight dogs while being fed a high-protein, high-fiber diet. All procedures were approved by the University of Illinois Institutional Animal Care and Use Committee prior to experimentation. Twelve overweight adult spayed female dogs (BW: 15.3±2.1 kg, BCS: 8.1±0.6) were fed a high-protein (CP: 42.0% DMB), high-fiber (TDF: 22.0% DMB) diet during a 5-wk baseline phase (wk 0) to identify food intake needed to maintain BW. A 24-wk weight loss phase followed. After wk 0, food was initially provided at 80% the amount needed to maintain BW and then adjusted weekly with a goal of 1.5–2% weight loss per wk. Data were analyzed statistically overtime using SAS 9.4. After 24 wk, dogs lost 31.2% of initial BW (P &amp;lt; 0.0001), with 1.4±0.7% weight loss per wk. BCS decreased by 2.8 units (P &amp;lt; 0.0001). During weight loss, dogs consumed an average of 457.5±61.4 kcal/d, with energy intake being reduced by a total of 43.8% by wk 24 compared to baseline. Lean muscle mass, fat mass, and fat percentage were reduced (P &amp;lt; 0.0001) by 1.3 kg, 3.1 kg, and 11.7% respectively. Serum triglycerides, alkaline phosphatase, white blood cell counts, and neutrophils were decreased (P &amp;lt; 0.0001), but serum bilirubin, creatinine, and blood urea nitrogen were increased (P &amp;lt; 0.01) over time. Average daily physical activity changed over time, but was not greatly different due to weight loss. Our results suggest that a high-protein, high-fiber diet promotes fat mass loss, minimizes lean muscle mass loss, and reduces inflammatory marker and triglyceride concentrations in overweight dogs. Therefore, it is a suitable nutritional solution for weight loss programs in dogs.

Physical activity and atrial fibrillation: Data from wearable fitness trackers

Regular physical activity is an important determinant of cardiovascular health and quality of life. Previous investigations examining the association between exercise and atrial fibrillation (AF) have been limited by self-reported, retrospectively collected activity data. The purpose of this study was to objectively quantify differences in daily physical activity among individuals with and those without AF using electronic wearable activity trackers. Daily exercise data were directly obtained from wrist-worn activity trackers (Fitbit, San Francisco, CA) among participants in the Health eHeart (HeH) study. Average daily step count was compared between individuals with and those without AF both before and after adjusting for comorbidities. AF severity was quantified using the Atrial Fibrillation Effect on QualiTy of Life (AFEQT) survey. Among 171,284 HeH study participants, 3333 individuals (234 with AF [7%]) submitted activity data. In unadjusted analysis, AF participants ambulated an average of 723 fewer steps per day (95% confidence interval [CI] 292-1154; P = .001) compared to individuals without AF. After adjustment for demographics and comorbid diseases, participants with AF demonstrated 591 fewer steps per day (95% CI 149-1033; P = .009). Among AF patients, AF severity was associated with less physical activity. For each single point decrease in AFEQT score (corresponding to more symptomatic AF), physical activity decreased by a mean 24 steps per day (95% CI 1-46; P = .04). Objective, automatically collected step count data demonstrate that individuals with AF engage in significantly less average daily physical activity. In addition, worsening AF symptom severity is associated with reduced daily exercise.

Patterns in Weight and Physical Activity Tracking Data Preceding a Stop in Weight Monitoring: Observational Analysis.

BackgroundSelf-regulation for weight loss requires regular self-monitoring of weight, but the frequency of weight tracking commonly declines over time.ObjectiveThis study aimed to investigate whether it is a decline in weight loss or a drop in motivation to lose weight (using physical activity tracking as a proxy) that may be prompting a stop in weight monitoring.MethodsWe analyzed weight and physical activity data from 1605 Withings Health Mate app users, who had set a weight loss goal and stopped tracking their weight for at least six weeks after a minimum of 16 weeks of continuous tracking. Mixed effects models compared weight change, average daily steps, and physical activity tracking frequency between a 4-week period of continuous tracking and a 4-week period preceding the stop in weight tracking. Additional mixed effects models investigated subsequent changes in physical activity data during 4 weeks of the 6-week long stop in weight tracking.ResultsPeople lost weight during continuous tracking (mean −0.47 kg, SD 1.73) but gained weight preceding the stop in weight tracking (mean 0.25 kg, SD 1.62; difference 0.71 kg; 95% CI 0.60 to 0.81). Average daily steps (beta=−220 daily steps per time period; 95% CI −320 to −120) and physical activity tracking frequency (beta=−3.4 days per time period; 95% CI −3.8 to −3.1) significantly declined from the continuous tracking to the pre-stop period. From pre-stop to post-stop, physical activity tracking frequency further decreased (beta=−6.6 days per time period; 95% CI −7.12 to −6.16), whereas daily step count on the day’s activity was measured increased (beta=110 daily steps per time period; 95% CI 50 to 170).ConclusionsIn the weeks before people stop tracking their weight, their physical activity and physical activity monitoring frequency decline. At the same time, weight increases, suggesting that declining motivation for weight control and difficulties with making use of negative weight feedback might explain why people stop tracking their weight. The increase in daily steps but decrease in physical activity tracking frequency post-stop might result from selective measurement of more active days.

Physical activity and risk of behavioural and mental health disorders in kindergarten children: analysis of a series of cross-sectional complete enumeration (census) surveys

ObjectivesThere is mixed evidence on the relationship between physical activity and behavioural and mental health. We aimed to estimate the association between physical activity and risk of behavioural and mental...